Goto Shunsaku, Kato Kyozo, Yamamoto Taiki, Shimato Shinji, Ohshima Tomotaka, Nishizawa Toshihisa
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Asian J Neurosurg. 2018 Apr-Jun;13(2):370-374. doi: 10.4103/ajns.AJNS_174_16.
Burr-hole irrigation surgery is now recognized as a widespread simple technique for the treatment of chronic subdural hematoma (CSDH). However, recurrence of CSDH is sometimes experienced after initial surgery. Recently, it has been reported that goreisan is effective in preventing CSDH recurrence.
Methods: We studied patients with CSDH who received burr-hole irrigation at our hospital between January 2011 and December 2014. We divided these patients into three groups. The first group was given goreisan during the early phase after burr-hole irrigation. The second group was given goreisan when there was a visual tendency of recurrence, as observed in the course of computed tomography imaging for outpatients. The third group was not given any drug.
The recurrence rate was compared between each group. The recurrence rate was significantly lower in the early goreisan administration group (5% vs. 12%, = 0.046). There was a decreased tendency of recurrence in the goreisan-administered group compared with the group that was not administered any drug, but this was not statistically different (6.1% vs. 12%, = 0.082). The recurrence period in the goreisan-administered group was longer than that in the group that was not administered any drug (39.9 ± 12.1 vs. 27.45 ± 8.5, = 0.017).
Goreisan is effective in preventing recurrence of CSDH after burr-hole irrigation.
目前,钻孔冲洗术被认为是治疗慢性硬膜下血肿(CSDH)的一种广泛应用的简单技术。然而,初次手术后CSDH有时会复发。最近,有报道称桂枝茯苓丸对预防CSDH复发有效。
我们研究了2011年1月至2014年12月在我院接受钻孔冲洗术的CSDH患者。我们将这些患者分为三组。第一组在钻孔冲洗术后早期给予桂枝茯苓丸。第二组在门诊计算机断层扫描成像过程中观察到有复发迹象时给予桂枝茯苓丸。第三组未给予任何药物。
比较了每组之间的复发率。早期给予桂枝茯苓丸组的复发率显著较低(5%对12%,P = 0.046)。与未给予任何药物的组相比,给予桂枝茯苓丸组的复发趋势有所降低,但差异无统计学意义(6.1%对12%,P = 0.082)。给予桂枝茯苓丸组的复发间隔时间比未给予任何药物的组长(39.9±12.1对27.45±8.5,P = 0.017)。
桂枝茯苓丸对预防钻孔冲洗术后CSDH复发有效。